Cleveland Clinic Surgeons Study New Weight Loss Surgery Technique

A new type of weight loss surgery involving folding a patient’s stomach inside itself and then stitching it could be a viable option for bariatric surgery patients, according to a pilot study conducted at Cleveland Clinic.

The 15-person prospective study was published in the online edition of the journal Surgery for Obesity and Related Diseases. It was led by Stacy Brethauer, M.D. and Philip Schauer, MD, Director of the Bariatric and Metabolic Institute at Cleveland Clinic.

The study evaluated the use of a technique called gastric plication, where the stomach is folded inside itself and then sutured in order to reduce its size.

“We can reduce the stomach volume by more than 2/3 without removing any of the stomach because we’re not cutting or stapling,” Dr. Schauer said. “Patients lose weight with gastric plication because their stomach is much smaller. It fills to capacity with a much smaller amount of food, so patients feel full quicker and therefore they eat less.”

Dr. Brethauer, the study’s lead author, said early weight loss results were encouraging.

“We need to conduct further studies to determine long-term weight loss,” he said. “A multi-center trial of this technique is ongoing, but our experience suggests this could be another good option for patients considering weight loss surgery.”

Twelve women and three men between the ages of 26 and 58 took part in the pilot study. Their average body mass index (BMI) before surgery was 44.3. People with BMIs of more than 40 are considered morbidly obese. A group of patients that had a smaller portion of their stomach folded saw 23 percent excess weight loss while a group with a larger portion of the stomach folded saw 53 percent excess weight loss.

Dr. Schauer said the preliminary results resemble the outcomes achieved through gastric sleeve procedures, which involves removing 80 percent of the stomach.

Gastric bypass is another commonly-used surgical technique. It involves creating a small pouch by dividing the upper end of the stomach, which restricts the intake of food. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach.

Disclosures: The study was funded by Ethicon Endo-Surgery; Drs. Brethauer, Schauer and their co-author, Matthew Kroh, MD, are consultants and speakers for Ethicon Endo-Surgery.

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Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and education. It was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. About 2,100 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. In addition to its main campus, Cleveland Clinic operates nine community hospitals and 15 Family Health Centers in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and opening in 2012, Cleveland Clinic Abu Dhabi. In 2009, there were more than 4.6 million visits throughout the Cleveland Clinic health system and 170,000 hospital admissions. Patients came for treatment from every state and from more than 100 countries. Visit us at www.clevelandclinic.org.

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